An Acceptance-Based Behavioral Intervention for Weight Loss: A Pilot Study☆
Highlights
► We tested the efficacy of an acceptance-based behavioral weight loss intervention. ► Participants were overweight and reported internal disinhibition. ► Average weight loss at 6-months was 12 kg and it was maintained at 3-month follow up. ► Acceptance-based approaches to weight loss warrant further study.
Section snippets
Participants
Participants were recruited via newspaper advertisements that sought individuals interested in weight loss who also have trouble controlling their eating when stressed. Potential participants were screened by phone and then in person to determine eligibility. Eligibility criteria included age between 21 and 70 years, body mass index (BMI) between 27 and 40 kg/m2, and a score of 5 or greater on the internal disinhibition subscale of the Eating Inventory (scores on this subscale range from 0 to 8).
Results
The 21 participants (19 females; 2 males) who entered the trial were age 52.2 ± 7.6 years, with a BMI of 32.8 ± 3.4 and body weight of 88.8 ± 11.2 kg. Ninety percent reported that they were non-Hispanic White, 4.8% Hispanic, and 4.8% other. Eighteen of 21 participants (86%) completed the 6-month assessment and 3-month follow-up. There were no baseline differences between completers and noncompleters on demographic characteristics (gender, education, racial/ethnic background) or outcome variables (BMI,
Discussion
This study piloted the use of an acceptance-based behavioral weight-loss intervention, evaluating its acceptability, feasibility, and initial effectiveness in individuals reporting high levels of internal disinhibition, or tendency to eat in response to emotional or cognitive cues. High levels of internal disinhibition have been associated with difficulty with both initial weight loss and weight-loss maintenance and may contribute to the high level of variability in outcome of standard
References (35)
- et al.
An open trial of an acceptance-based behavioral intervention for weight loss
Cognitive and Behavior Practice
(2009) - et al.
A comparison of acceptance- and control-based strategies for coping with food cravings: An analog study
Behaviour Research and Therapy
(2007) - et al.
Acceptance-based treatment for persons with complex, long standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase
Behaviour Research and Therapy
(2005) - et al.
The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger
Journal of Psychosomatic Research
(1985) - et al.
Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women
Appetite
(2009) - et al.
A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania
Behaviour Research and Therapy
(2006) - et al.
Cognitive-behavioral treatment for depression in alcoholism
Journal of Consulting and Clinical Psychology
(1997) - et al.
Distress tolerance and duration of past smoking cessation attempts
Journal of Abnormal Psychology
(2002) - et al.
Distress tolerance treatment for early-lapse smokers: Rationale, program description, and preliminary findings
Behavior Modification
(2008) - et al.
Reductions in internal disinhibition during weight loss predict better weight loss maintenance
Obesity
(2009)
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
New England Journal of Medicine
State-level estimates of annual medical expenditures attributable to obesity
Obesity Research
Excess deaths associated with underweight, overweight, and obesity
Journal of the American Medical Association
Preliminary outcomes from the Mind Your Health project: A randomized controlled trial comparing standard behavioral and acceptance-based behavioral interventions for obesity
A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression
Behavior Modification
Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial
Journal of Consulting and Clinical Psychology
Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study
International Journal of Obesity and Related Metabolic Disorders
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2022, AppetiteCitation Excerpt :The AAQ and AAQ-II are currently the most widely used measures of psychological inflexibility (or experiential avoidance) (Bond et al., 2011). Nine studies (Afari et al., 2019; Levin et al., 2021; Levin et al., 2018; Lillis et al., 2009; Lillis et al., 2016; Niemeier et al., 2012; Potts et al., 2020; Sairanen et al., 2017; Weineland, Arvidsson, et al., 2012) administered the 22-item Acceptance and Action Questionnaire for Weight-Related Difficulties (AAQ-W) (Lillis & Hayes, 2008), which measures psychological inflexibility specifically related to difficult weight-related thoughts, feelings and actions. Seven studies (Berbette, 2016; Bradley et al., 2016; Carels et al., 2019; Forman et al., 2009; Frayn et al., 2019; Juarascio et al., 2017; Katterman et al., 2014) used the 10-item Food Craving Acceptance and Action Questionnaire (FAAQ) (Juarascio, Forman, Timko, Butryn, & Goodwin, 2011) to assess acceptance of internal experiences that pertain to food and eating such as urges, thoughts, and cravings.
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The authors would like to thank Rheanna Ata; Jacki Hecht, RN; Erica Robichaud, MSW, RD; and Victoria Winn for their invaluable assistance on this project. This research was supported by Grant 5K23-DK73536 from the National Institutes of Health.